Purpose. To evaluate interobserver, intervisit, and interinstrument agreements for gonioscopy and Fourier domain anterior segment optical coherence tomography (FD ASOCT) for classifying open and narrow angle eyes. Methods. Eighty-six eyes with open or narrow anterior chamber angles were included. The superior angle was classified open or narrow by 2 of 5 glaucoma specialists using gonioscopy and imaged by FD ASOCT in the dark. The superior angle of each FD ASOCT image was graded as open or narrow by 2 masked readers. The same procedures were repeated within 6 months. Kappas for interobserver and intervisit agreements for each instrument and interinstrument agreements were calculated. Results. The mean age was 50.9 (±18.4) years. Interobserver agreements were moderate to good for both gonioscopy (0.57 and 0.69) and FD ASOCT (0.58 and 0.75). Intervisit agreements were moderate to excellent for both gonioscopy (0.53 to 0.86) and FD ASOCT (0.57 and 0.85). Interinstrument agreements were fair to good (0.34 to 0.63), with FD ASOCT classifying more angles as narrow than gonioscopy. Conclusions. Both gonioscopy and FD ASOCT examiners were internally consistent with similar interobserver and intervisit agreements for angle classification. Agreement between instruments was fair to good, with FD ASOCT classifying more angles as narrow than gonioscopy.
Purpose
To evaluate discrepancies in doses per bottle, bottle fill volume, and cost among branded and generic formulations of latanoprost
Design
Comparative economic analysis
Methods
This study was conducted at the Ruiz Department of Ophthalmology and Visual Science at The University of Texas Health Science Center at Houston (UTHealth). Four regionally available latanoprost formulations were measured. Number of drops per bottle and actual bottle fill volume were measured for a calculated sample size (10 bottles). Annual cost (using average wholesale price), days use per bottle, drops per milliliter, and number of bottles used per year were calculated. Data were summarized using mean and standard deviation; one-way analysis of variance and post hoc Tukey's studentized range test were used for comparing means among manufactures.
Results
Pfizer's branded lantanoprost, Xalatan (New York, NY), had the largest fill volume (P<0.001). Pfizer had the highest yearly cost at $1,198 (P<0.001) whereas Akorn (Lake Forest, IL) and Bausch & Lomb (Rochester, NY) had the lowest ($184 and $201, respectively). Pfizer and Bausch & Lomb had the most drops per bottle (87.3 and 88.7, respectively), which was statistically more (P<0.001) than either Akorn or Sandoz (Princeton, NJ) (77.6 and 76.6, respectively) but there was no statistical difference among the standard deviation of drops per bottle (Levene 0.14).
Conclusions
Annual cost and number of doses per bottle, factors important to patients, vary significantly depending on manufacturer of latanoprost. Practitioners can better advise patients being aware of these differences.
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